| NPI | 1790511442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKHIL JHUNJHNUWALA Operations Manager 385-327-2541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2025-09-11 |