| NPI | 1093154593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS LEE WATSON Physician 760-480-9051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A52193) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2018-03-07 |