| NPI | 1083001010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY K WILDE CEO And President 805-652-5011 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2021-11-16 |