NPI | 1720417967 |
---|---|
Entity Type | Organization |
Authorized Contact | FAITH A ROEDIGER DE BONILLA Credentialing/Contracting Specialis 916-226-3736 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX f7329) |
261QI0500X Clinic/Center, Infusion Therapy | |
364SW0102X Clinical Nurse Specialist, Women's Health (Licence: TX 533613) | |
Enumeration Date | 2013-11-07 |
Last Update Date | 2017-10-13 |