| NPI | 1912908930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFONSO BANUELOS Chief Medical Officer 408-885-4010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 432283) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2020-08-22 |