| NPI | 1659399202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM D. MCDONALD Owner/Authorized Official,(Per Peco 209-476-0675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A31110) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G74876) |
| 213E00000X Podiatrist (Licence: CA E3287) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-11-23 |