| NPI | 1043636335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PIERRE FRANK FAYO FIRMALINO Owner/President 909-393-5501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA B39402) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2015-10-27 |