| NPI | 1982980199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELLE MAHAN Physician Administrator 707-822-3621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G71860) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2011-11-01 |