| NPI | 1558120436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MOYNIHAN Interim Medical Director 916-296-0495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-03-25 |