| NPI | 1326824129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA BAXTER Manager 408-667-1715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2023-10-18 |