| NPI | 1396282406 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JACOB WOLF Credentialing Department 209-956-9166  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA C138466)  | 
| Enumeration Date | 2017-01-26 | 
| Last Update Date | 2019-10-03 |