Jackie A Bolds Valid NPI

Individual provider · Multi-Specialty Clinic/Center · Newark, CA

NPI

1356497101

Type

Individual (Type 1)

Primary specialty

Multi-Specialty Clinic/Center (Clinic/Center)

Specialty group

Ambulatory Health Care Facilities

Taxonomy code

261QM1300X

License number

G57227 (CA)

Sex

Male

Sole proprietor

Yes

Enumerated

2007-01-26

Last updated

2007-07-08