| NPI | 1740866615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA LEE CEO 707-275-6383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM |
| 213E00000X Podiatrist | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2021-09-30 |