| NPI | 1023558483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM LOAN HUYNH Owner 267-982-7685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: PA AT006416) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2019-12-20 |