| NPI | 1851900344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEOPHILE KOURY Admin Vice President Of Ops 510-350-2842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2021-05-12 |