| NPI | 1427676873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SVETLANA DANI Owner 408-559-3889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 2080S0010X Pediatrics Sports Medicine | |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-11-25 |