| NPI | 1194103796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYNITA ATALIG Practice Manager 707-551-3319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2021-08-04 |