| NPI | 1528012978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY SCOTT HARMON Administrator/ Don 209-668-9866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 550000135) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2023-05-22 |