| NPI | 1841644671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOR GAVISH M.A, Mft 415-890-6394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 81239) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |