| NPI | 1306057849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAQUEL DE LOS SANTOS Medical Biller 559-322-7766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A51804) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2008-01-07 |