N/a
NPI #1194055749 in Antioch, California
Provider Information
- NPI Number
- 1194055749
- Entity Type
- Organization
- Organization Name
- N/a
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jan 4, 2010
- Last Updated
- Jan 4, 2010
Practice Location
- Address
- 4051 LONE TREE WAY STE C
- City
- Antioch
- State
- California
- ZIP Code
- 94531-6204
- Phone
- (925) 757-2900
Authorized Official
- Name
- MR. KEVIN ROLAND MARTIN
- Title
- PHLEBOTOMIST
- Phone
- (925) 458-5124
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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