| NPI | 1316190796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN A MITNICK Medical Director 209-521-6097 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2020-03-06 |