NPI | 1245545664 |
---|---|
Entity Type | Organization |
Authorized Contact | J EDWARD BERNARDO MADDELA President/CEO/Incorporator 707-319-9790 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2010-08-10 |
Last Update Date | 2010-08-12 |