| NPI | 1649500877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN ROBERT SHAW Medical Director 805-644-4809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA G47926) |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2010-01-11 |