| NPI | 1417388364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COYNESS ENNIX Authorized Official 510-459-3547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2013-12-03 |