| NPI | 1821480153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANA ROMO Office Manager 916-538-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 57798) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-02-24 |