| NPI | 1902121734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYE A DONNELLY Credentialing COO Rdinator 707-968-2809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA G88201) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2010-04-05 |