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 |