| NPI | 1730920141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYDEL MIRANDA CEO 209-456-4323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2024-06-03 |