| NPI | 1447380597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY MCMANUS Medical Director 805-646-6406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: CA 171W00000X) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |