| NPI | 1932252053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTERIA RANDALL KOAYEN Clinician 510-532-1930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 372500000X Chore Provider (Licence: CA 439624) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |