| NPI | 1548238256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNETTE M HENRIOD Practice Administrator 805-499-0308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA PA13286) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2020-08-22 |