NPI | 1639472301 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK E WOLPA President/ Owner 510-849-3800 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA E1852) |
Enumeration Date | 2010-12-17 |
Last Update Date | 2014-05-06 |