| NPI | 1558543272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANCARLOS BULLER President 707-253-1393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A066601) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A66060) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: CA A066601) | |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-05 |