| NPI | 1508625534 |
|---|---|
| Doing Business As | SAN PEDRO |
| Doing Business As | ELMWOOD |
| Entity Type | Organization |
| Authorized Contact | PAUL E LORENZ Chief Executive Officer 408-885-4010 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health |
| Enumeration Date | 2024-03-13 |
| Last Update Date | 2024-03-26 |