| NPI | 1427361138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLENE A MOORE Registered Nurse 530-873-0830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 251108) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2010-07-22 |