| NPI | 1053717280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO ROSSELLI Director Of Managed Care Operations 619-344-2815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |