| NPI | 1700034261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEE DEE CASTRO Practice Manager 805-658-9112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A76116) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A74590) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2008-09-08 |