| NPI | 1568792711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T BAKOS Medical Director 916-987-5360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A67792) |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2010-08-28 |