| NPI | 1700948114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA L PASQUINELLI Provider Enrollment COO Rdinator 650-498-5710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |