| NPI | 1336955699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK KEHRET Administrator 925-519-2688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363L00000X Nurse Practitioner | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2025-12-09 |