| NPI | 1053350884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE ALEX LIRA Medical Director 909-591-6446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QE0800X Clinic/Center, Endoscopy |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-08-22 |