| NPI | 1033449640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BEROOZ LAJVARDI Owner 619-460-7775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A89608) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A89608) |
| Enumeration Date | 2010-01-04 |
| Last Update Date | 2023-10-05 |