| NPI | 1316158140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BRIAN DUHAMEL Owner 209-772-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: CA 23820) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: CA 23820) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2019-04-29 |