| NPI | 1902086606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHAM NGUYEN Vice President 408-240-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA D52747) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA D52747) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2019-12-16 |