| NPI | 1932663853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERUSHA NORMAN Compliance Administrator 510-994-6849 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171W00000X Contractor | |
| 251X00000X | |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2022-03-28 |