NPI | 1689066029 |
---|---|
Entity Type | Organization |
Authorized Contact | SILVIA M DIEGO Principle Officer 209-522-3362 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2015-02-23 |
Last Update Date | 2025-08-26 |