| NPI | 1902852510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLASH GORDON Owner , CEO 415-461-2262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA G37304) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A61715) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2014-12-02 |