| NPI | 1699087072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE GENARGUE ENAD Administrator 209-384-9108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A49631) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA C50505) |
| 261QP2300X Clinic/Center, Primary Care (Licence: CA A54997) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |