| NPI | 1295155638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAO Q NGUYEN Owner 209-475-8144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2020-06-03 |