| NPI | 1790712990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE BOHNA Supervisor 209-464-3615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA FNP33233) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-03-02 |