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 |