| NPI | 1740607456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA GREEN Administrator 510-262-0206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA 079200302) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2014-03-20 |