| NPI | 1336577154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMON O PORTER Director Of Clinical Operations 510-612-2692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CA 28040527) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2013-10-15 |