| NPI | 1932310919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERAH KHAN Facilitator 916-388-6346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 305R00000X) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2008-06-20 |