| NPI | 1376765537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN ROEHLK Admin. Assist. Credendialing 209-385-5434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 040000215) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 040000215) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2025-09-11 |