| NPI | 1982420329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAKHTAR EHSAN CFO 831-325-3541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2025-05-20 |