| NPI | 1477752673 |
|---|---|
| Doing Business As | THE 14TH STREET CLINIC |
| Entity Type | Organization |
| Authorized Contact | JOAN ELLEN ZWEBEN President 510-526-4442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CA 01-20) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2007-07-17 |