| NPI | 1851699052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PAIK-TESCH Program Director 209-564-3513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A116159) |
| Additional Taxonomies | 261QB0400X Clinic/Center, Birthing (Licence: CA A116159) |
| 261QU0200X Clinic/Center, Urgent Care (Licence: CA A116159) | |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2011-03-11 |