| NPI | 1285759712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDELLE MARIE DELPH Health Services Technician 707-765-7702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2007-11-14 |