| NPI | 1104622554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAZEL LLOCE Practice Manager 760-542-6615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-02-24 |