| NPI | 1790910610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTASHE NYOKU GOLDEN Medical Director 916-837-1966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA A70035) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2009-05-21 |