| NPI | 1093508038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY COX Owner 909-802-6095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2025-05-23 |
| Last Update Date | 2025-10-29 |