| NPI | 1023977089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE FOMBONA Student Intern 661-340-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2026-01-16 |
| Last Update Date | 2026-01-23 |