| NPI | 1821092206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARISSA T FEGAN Administrator Sfsc 707-432-2710 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: CA 110000525) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2014-06-27 |