| NPI | 1275903833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE JESSE LAZATIN Physician/Owner 916-300-7534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO 50291) |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |