| NPI | 1245637123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERILYN SUE CAGLE Busienss Office Manager 805-786-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 52086) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2014-11-20 |