| NPI | 1629372073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE MILLER Manager 916-365-3431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A64163) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2022-07-20 |