| NPI | 1053438408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNIE GROFF Clinic Manager 909-381-0803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA 2970942) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2009-03-16 |