| NPI | 1922091487 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DIANA J. DAUGHERTY Office Manager 805-349-1202  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G074101)  | 
| Enumeration Date | 2005-08-30 | 
| Last Update Date | 2008-11-03 |