| NPI | 1356800569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN L CHEN Legal Counsel 800-475-6168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| 102L00000X Psychoanalyst | |
| 103G00000X Clinical Neuropsychologist | |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| 207P00000X Emergency Medicine | |
| 207QA0000X Family Medicine, Adolescent Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2022-04-06 |