| NPI | 1639183486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP A EDINGTON Director 209-948-5515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 30000469) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |