| NPI | 1366788598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON G. PARK President 209-667-1606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA G32541) |
| Enumeration Date | 2012-12-16 |
| Last Update Date | 2012-12-16 |