| NPI | 1710358924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOHANNES GEBREEGZIABHER Partner 209-575-4575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
| 207QA0505X Family Medicine, Adult Medicine | |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |