| NPI | 1063694479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAY VIERRA Interim Director 909-869-2760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: CA 306630) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2007-11-28 |