| NPI | 1003053398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN VIGIL Manager 909-941-0661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA 20A7446) |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2009-01-08 |