| NPI | 1770993370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY LOCKHART REGUERA Owner 530-515-4202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 246XS1301X Spec/Tech, Cardiovascular, Sonography | |
| 2471C3402X Radiologic Technologist, Radiography | |
| 2471S1302X Radiologic Technologist, Sonography | |
| 2471V0105X Radiologic Technologist, Vascular Sonography | |
| 261Q00000X Clinic/Center | |
| 261QR0200X Clinic/Center, Radiology | |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2015-08-11 |