| NPI | 1114062163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VELMA ESTELLA VISCARRA Provider Enrollment 562-440-7901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A34431) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2014-03-14 |