| NPI | 1164605838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE LOUISE ROACH Registered Nurse 916-734-7006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 397650) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2007-12-17 |