| NPI | 1083273684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNENE GRAHAM Practice Manager 858-943-2540 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2025-08-13 |