| NPI | 1376767665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT SAM FONG Pediatric Social Worker 916-734-1665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |