| NPI | 1013278670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN STANLEY WILDISH Manager 951-378-3605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: CA G60605) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-05-30 |