| NPI | 1760092035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN L CHEN Legal Counsel 800-475-6168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2022-04-06 |