| NPI | 1083055545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BABAK EGHBALIEH President 855-946-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine | |
| 207R00000X Internal Medicine | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2013-07-12 |