| 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 |