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 |