| NPI | 1730112178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANEE TAVARES Adminstrator 209-948-3241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 030000469) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2024-02-26 |