| NPI | 1023141686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG KISHABA Senior Administrative Director 619-278-3301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2025-09-11 |