| NPI | 1780878538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY HARRIS Office Manager 925-830-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 50298) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: CA 50281) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-09-04 |