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 |