| NPI | 1912697129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE HALE Owner 805-291-7789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 251S00000X |
| 261QD0000X Clinic/Center, Dental | |
| 251B00000X Case Management | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2023-05-10 |