| NPI | 1497125868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNELLE MCDERMOTT Administrator 805-499-4446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 111N00000X Chiropractor | |
| 171100000X Acupuncturist | |
| 225100000X Physical Therapist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2016-09-08 |