| NPI | 1952048514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT D NEELEY Owner/Authorized Official 707-263-1328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2022-07-18 |