| NPI | 1790971851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODOLFO A DAQUIOAG Practice Owner 707-426-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A29896) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2007-09-21 |