| NPI | 1730234808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA MARIA RIOS Mtfc Program Supervisor 559-281-3687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2008-08-11 |