| NPI | 1033368741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA NORTON PETROVICH Owner/President 619-435-2234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A72085) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A72085) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2016-02-08 |