| NPI | 1497924260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA ELISE FORESMAN Office Manager 805-481-3442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA G66487) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2011-09-21 |