| NPI | 1386054013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT BREINIG MELGOSA Owner/President/CEO 209-634-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 61429) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2014-05-02 |