| NPI | 1134880818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN CERF President & CEO Blue Shield Ca Prom 510-607-4376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care |
| 208000000X Pediatrics | |
| 208VP0000X Pain Medicine Pain Medicine | |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2022-01-05 |