| NPI | 1326195058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINNE VIVIAN BASCH Owner 707-840-4701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A51185) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2016-10-09 |