| NPI | 1215283866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ALEXANDER FLATTER Medical Director 209-603-4955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2024-05-01 |