NPI | 1922155191 |
---|---|
Entity Type | Organization |
Authorized Contact | MAUREEN MALONE Front Office Manager 805-497-3239 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: CA G50708) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A63292) |
207R00000X Internal Medicine (Licence: CA A41849) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: CA G73949) | |
208600000X Surgery (Licence: CA A39905) | |
Enumeration Date | 2007-01-03 |
Last Update Date | 2025-09-11 |