| NPI | 1417369943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT EUGENE SULLIVAN Sole Owner 916-978-9777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA G31309) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2014-06-02 |