NPI | 1174978688 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY S PETERSON Owner 650-704-7094 |
Organization Subpart ? | No |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: CA A65906) |
Additional Taxonomies | 2083S0010X Preventive Medicine, Sports Medicine (Licence: CA A65906) |
Enumeration Date | 2016-05-03 |
Last Update Date | 2016-05-03 |