| NPI | 1710203245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON M SCOTT Physician 408-246-9915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA 20A5858) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2010-05-13 |