| NPI | 1922155191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN MALONE Front Office Manager 805-497-3239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A63292) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A41849) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G73949) | |
| 208600000X Surgery (Licence: CA A39905) | |
| 208D00000X General Practice (Licence: CA G50708) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |