| NPI | 1902106982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS N BORNER President 408-852-0703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 17859) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 17859) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 17859) | |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2010-10-25 |