| NPI | 1164191417 |
|---|---|
| Doing Business As | GENERATIVE HEALTH MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | GLEN L XIONG CEO 916-471-8838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2021-11-11 |