| NPI | 1841614963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARIQ MIRZA Owner 510-754-0729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA A84987) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2014-02-20 |