| NPI | 1376671206 |
|---|---|
| Other Name | NONE |
| Entity Type | Organization |
| Authorized Contact | SPENCER TIMOTHY LOWE Medical Director 650-692-8804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A440070) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2008-03-10 |