| NPI | 1811185705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA JORDAN President 916-525-2021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A53618) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A53618) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-04 |