| NPI | 1215023056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA ANN HOFF Practice Administrator 707-755-5405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA GR0046620) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2023-07-26 |