| NPI | 1073889556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIANN E CHANG President 760-256-3508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 00A30510) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |