| NPI | 1962791293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEOPHILE KOURY COO 510-350-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2013-08-19 |