| NPI | 1043603657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVIER HERNANDEZ President 760-625-9870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A77736) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA RN500867) |
| Enumeration Date | 2015-03-07 |
| Last Update Date | 2015-03-09 |