| NPI | 1851266589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYNA NGUYEN Manager 916-317-8796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2025-10-10 |
| Last Update Date | 2025-10-10 |