| NPI | 1699158634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA FERGUSON Billing Manager 707-498-7040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA G59380) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2015-07-08 |