| NPI | 1588051106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON LABUGUEN Interim Medical Director 415-206-8611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-04-21 |