| NPI | 1568646610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CHARLES SHULKIN Owner 707-542-3404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA OPT77030TPA) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA OPT77030TPA) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2008-03-27 |