| NPI | 1043565096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA DI SARLI Administration 909-868-6666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: CA COMMUNITY CLINIC) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA COMMUNITY CLINIC) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2012-07-16 |