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 |