| NPI | 1417179714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE LOUISE BURKE President 916-983-5771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G079569) |
| Additional Taxonomies | 209800000X Legal Medicine (Licence: CA G79569) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: CA G079569) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2011-02-04 |