| NPI | 1649434812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIEZL TORREFIEL Trainee 650-494-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 106H0000X) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2008-07-16 |