| NPI | 1265183594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYDILI MANIAM-MOHAN Physician / President 559-530-3073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2022-01-18 |