NPI | 1770614281 |
---|---|
Entity Type | Organization |
Authorized Contact | KIRK S. GILBERT Medical Director 805-687-1505 |
Organization Subpart ? | No |
Primary Taxonomy | 171W00000X Contractor (Licence: CA 171W00000X) |
Enumeration Date | 2007-03-08 |
Last Update Date | 2020-08-22 |