| NPI | 1134391030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY LEE MANOUKIAN Owner 650-940-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA G64508) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-07-03 |