| NPI | 1760536734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEPAK MEHTA Physician And Surgeon 707-448-6841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health (Licence: CA A0063312) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |