| NPI | 1609055698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY RUSTIN Office Manager 916-966-6139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G23760) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA G23760) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2007-10-26 |