| NPI | 1750044210 |
|---|---|
| Doing Business As | PG&E SAN CARLOS |
| Entity Type | Organization |
| Authorized Contact | JON LEIZMAN President 615-468-6270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2023-09-08 |