| NPI | 1578961843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STUART I JACOBS President Of Corporation 209-957-6662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G30790) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2015-03-30 |