| NPI | 1750494522 |
|---|---|
| Former Legal Business Name | PHOENIX WELLNESS GROUP |
| Entity Type | Organization |
| Authorized Contact | BARBARA MOSS KELLER Business Director 650-888-2290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G058061) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2009-03-23 |