| NPI | 1104150580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE FINCH Office Manager 909-902-5588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: 34087) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2009-10-30 |