NPI | 1225241482 |
---|---|
Entity Type | Organization |
Authorized Contact | HELEN ROEHLK Adm. Assist. Credentialing 209-385-5434 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 040000300) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA 040000300) |
Enumeration Date | 2007-05-07 |
Last Update Date | 2020-08-22 |