| NPI | 1114388659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCTAVIO RUIZ-VILLALPANDO Medical Director 909-815-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A92039) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2016-03-11 |