| NPI | 1215578885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY CLINE Md 707-992-5809 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2022-08-18 |