| NPI | 1154675742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL O MOMOH President 408-730-6819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA GH102230817) |
| 305S00000X Point of Service (Licence: CA GH102230817) | |
| 291900000X Military Clinical Medical Laboratory (Licence: CA GH102230817) | |
| Enumeration Date | 2012-11-04 |
| Last Update Date | 2014-01-21 |