NPI | 1508514902 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREA M SKELLY Billing Manager 415-798-3135 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
207V00000X Obstetrics & Gynecology | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2022-03-15 |
Last Update Date | 2022-10-03 |