NPI | 1063567394 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN FRANKLIN RANDOLPH President 909-580-6260 |
Organization Subpart ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
Enumeration Date | 2007-01-25 |
Last Update Date | 2009-12-18 |