| NPI | 1073968517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PANKAJ NAKARANI COO 909-479-9260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX p0505) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TX N8334) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2024-04-19 |