| NPI | 1255469110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY MARIE HEMMER Office Manager 209-465-5655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 243-2034-3) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |