| NPI | 1093514374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAHEED BAQAI Administrator 909-710-7887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-09-25 |