| NPI | 1063663656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTEBAN PONI Owner 951-288-6688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A93185) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A93185) |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2008-10-01 |