| NPI | 1689628844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK JOHN MULLIN Manager 916-689-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA FNP34722) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-08-22 |