| NPI | 1073058103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SADIQ MANDILAWI Co Owner 909-596-4879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2018-04-23 |