| NPI | 1235551037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEY THI DOMINGUEZ Manager 916-422-7273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 225933) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2014-01-13 |