| NPI | 1104715317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALMOUTAZ B SHAKALLY Owner 909-696-9626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2025-07-01 |
| Last Update Date | 2025-07-01 |