| NPI | 1861910010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASSANDRA WALKOWIAK Dr. 805-482-0105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: CA DC33749) |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2022-07-21 |