| NPI | 1659537264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK THEODORE FAHLEN President 209-544-2910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: CA A81212) |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2011-08-02 |