| NPI | 1972657393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA J MCDONALD Practice Administrator 916-290-8672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G42424) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2013-10-24 |