| NPI | 1750171021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL BRANDAN STARK Do President 530-514-0904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2025-05-09 |
| Last Update Date | 2025-05-09 |