| NPI | 1689729352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL KODZO TANSON Medical Director 209-472-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A325500) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2021-03-03 |