| NPI | 1487984670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA L CASSELLIUS Credentialing 805-482-7260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A101489) |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2010-05-26 |