| NPI | 1790231256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS COLYVAS Medical Director 415-409-1367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA A050788) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2017-02-23 |