| NPI | 1699483701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS STANIS Chief Administrative Officer 408-898-4940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2022-11-08 |
| Last Update Date | 2023-06-30 |