| NPI | 1992288385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY N VANBANG Director 408-307-0560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2024-06-28 |