| NPI | 1063611580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY MARIE MONTANO Medical Administrative Officer 619-744-5354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2007-07-13 |