| NPI | 1508075482 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | RECTO FERNANDEZ DELEON Physician 209-527-7677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A24912) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |