| NPI | 1508052572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M PHILLIPS Credentialing Specialist 707-473-4531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2022-07-21 |