| NPI | 1114222155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY NELSON Office Manager 619-875-2865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA C52423) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA C52581) |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2023-05-17 |