| NPI | 1568847424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN GLYN PAWSON Owner 916-792-0141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA Not required) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-07-21 |