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 |