| NPI | 1710041058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERRY RODRIGUEZ Clinic Administrator 707-765-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2009-05-07 |