| NPI | 1841521770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUISA MERCEDES ABARCA-BASILE Health Services Administrator 925-833-7500 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2400X Clinic/Center Prison Health (Licence: MN 33616) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: CA A41553) |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-01-15 |