| NPI | 1255490231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILBERT ELDON GREENE Owner President 209-464-7757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A4367) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-08-22 |