NPI | 1730691171 |
---|---|
Entity Type | Organization |
Authorized Contact | DEANE WALLACE Credentialing Specialist 916-571-9041 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
Enumeration Date | 2017-10-25 |
Last Update Date | 2017-10-25 |