| NPI | 1467678391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM JAMES STACY Owner 805-208-0434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA NP 15005) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2021-10-08 |