NPI | 1205274255 |
---|---|
Former Legal Business Name | OPTIMAGE |
Entity Type | Organization |
Authorized Contact | DEBORAH DAWN MOTYKA Owner 831-421-0197 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G63571) |
Enumeration Date | 2013-06-12 |
Last Update Date | 2013-12-27 |