| NPI | 1821412636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD R PETERSON Owner/Physician 916-784-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA G22928) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G22928) |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC27635) | |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC38009) | |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2015-01-16 |