| NPI | 1467772228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN MASTERSON Medical Biller 209-525-3199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A42295) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2010-06-03 |