| NPI | 1649471798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS HERSHEY Medical Director 916-736-6888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 189620) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: CA CLF10469) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2018-05-31 |