| NPI | 1538225156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEU VANG Manager 209-957-3901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 00A373770) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 00A373770) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2009-10-13 |