| NPI | 1942200746 |
|---|---|
| Doing Business As | LOGAN STREET MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | STANLEY YOUNG LOUIE Presiden/Medical Director 559-896-2624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20a65700) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2020-08-22 |