| NPI | 1205911716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMAKRISHNA R THONDAPU Medical Director 209-724-0316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: CA 550000054) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 550000054) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2017-11-30 |