| NPI | 1851682850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTIL FERGUSON Financial/Billing Manager 707-462-0681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2011-04-25 |