| NPI | 1952911331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA JORDAN Physician 916-525-2021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 208D00000X General Practice | |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-07-31 |