| NPI | 1114120417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE MARIE WALKER Contracts Manager 909-398-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2025-09-11 |