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 |