| NPI | 1760863039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILDRETH RODRIGUES Ar And Billing Manager 707-273-2675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: FL DN13684) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: FL DN13684) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: FL DN13684) | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-06-12 |