| NPI | 1568679785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REZA BAYATI Director 916-626-4838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MI 4301066754) |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty (Licence: CA C52426) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2014-08-07 |