| NPI | 1427181221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY GINGRAS VP Of Finance And Administration 510-869-1588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E-2309) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E-4490) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |