| NPI | 1538658844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY L BASSO Vice President 530-979-6226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QP1100X Clinic/Center, Podiatric | |
| 261QP3300X Clinic/Center, Pain | |
| 261QR1100X Clinic/Center, Research | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2018-05-02 |