| NPI | 1407466477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ALAN GERACI Credentialing Manager 650-398-6329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2023-12-05 |