| NPI | 1336771088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON RANDOLPH VANCE Authorized Official 530-588-2689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-07-10 |