NPI: 1477615797 · LOS BANOS, CA 93635 · Administrator Registered Nurse · NPI assigned 12/14/2006
| Authorized Official | PALLIVATHUCAL, JOSPEH (GENERAL MANAGER) |
| NPI Enumeration Date | 12/14/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 14 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0100 | 14 | 14 | $10K |