| NPI | 1104074459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANN A. GAGE President And Executive Director 619-260-0810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CA RN456541NP5830) |
| Additional Taxonomies | 133N00000X Nutritionist |
| 163WN1003X Registered Nurse, Nutrition Support (Licence: CA RN456541NP5830) | |
| 171100000X Acupuncturist (Licence: CA AC5147) | |
| 208D00000X General Practice (Licence: CA C51231) | |
| 261Q00000X Clinic/Center | |
| 363L00000X Nurse Practitioner (Licence: CA RN456541NP5830) | |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2022-09-28 |