| NPI | 1497589097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL FENTON Owner 415-505-7922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-08-27 |
| Last Update Date | 2024-09-12 |