| NPI | 1114385655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DOAN Chief Compliance Counsel 909-235-4307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 213E00000X Podiatrist | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2023-09-05 |