| NPI | 1881443422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BREANA CHRISTINE COVILLE Pa C, Co Owner 805-427-4231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2024-05-15 |