NPI | 1710170394 |
---|---|
Entity Type | Organization |
Authorized Contact | ALICIA BOELKE Supervisor 209-385-7840 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA 540215) |
Enumeration Date | 2007-08-27 |
Last Update Date | 2007-08-27 |