| NPI | 1013151364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJU KHANCHUSTAMBHAM Director 760-217-0126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A86478) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2009-05-11 |