| NPI | 1699054650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYE A DONNELLY Specialist, Contract Compliance 707-968-2809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 208600000X Surgery | |
| 208800000X Urology | |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2011-08-09 |