| NPI | 1326038381 |
|---|---|
| Other Name | MANGROVE LAB & XRAY |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH A MULLINS Administrator 530-345-0064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| 207ND0900X Dermatology, Dermatopathology | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| 208D00000X General Practice | |
| 261QR0206X Clinic/Center, Radiology, Mammography (Licence: CA RHC 110619) | |
| 291U00000X Clinical Medical Laboratory (Licence: CA 05DO644223) | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2022-01-04 |