| NPI | 1710254313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI A ABDUL WAHID Fp 209-988-0873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A106703) |
| Enumeration Date | 2011-11-27 |
| Last Update Date | 2015-01-05 |