| NPI | 1356394480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAUFOUINA A AFATO Medical Director CEO 550-674-7000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: CA G76223) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 4476370001) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2016-10-24 |