| NPI | 1568646826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN SAM DAVIDSON Owner 209-751-7165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: CA G66389) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G66389) |
| 207RS0012X Internal Medicine, Sleep Medicine (Licence: CA G66389) | |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2013-08-16 |