| NPI | 1760230056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY CAMPOS CFO 916-233-6769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 164W00000X Licensed Practical Nurse | |
| 207Q00000X Family Medicine | |
| 208D00000X General Practice | |
| 231H00000X Audiologist | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2024-05-10 |
| Last Update Date | 2024-05-10 |