| NPI | 1275567919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON HARDY Director Provider Enrollment 925-251-6901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-01-10 |