| NPI | 1164962684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY HAHN CHEN Chronic Conditions Manager 628-242-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA 824984) |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-02 |