| NPI | 1780953596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUNTU R DAVIS Medical Director 510-267-8010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| 261QS1000X Clinic/Center Student Health | |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2012-05-11 |