| NPI | 1982151676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE ALLEN ROBERTS CFO, Medical Director 415-964-0546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: CA C53920) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2016-09-09 |