NPI | 1063825289 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELICA LEYLA SOTO Credentialing Specialist 855-434-7763 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A12647) |
Enumeration Date | 2014-06-05 |
Last Update Date | 2024-05-21 |