| 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 |