| NPI | 1518188366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELAINE MABUNGA AQUINO President 209-943-6740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 07-00087928) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2011-03-07 |