| NPI | 1154785517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY TIU CEO 209-384-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease |
| 213E00000X Podiatrist | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2021-10-12 |