| NPI | 1417391541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN WARREN GILLON Owner 650-364-3828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA G56808) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2013-04-19 |