| NPI | 1053713206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE PITTS Administrator 661-843-7841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA PA20231) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A42316) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |