| NPI | 1083917918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES SHANER Doctor 760-864-6688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA G25057) |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2011-03-21 |