| NPI | 1114587813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD GAMBOA CEO 702-488-4198 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine |
| 261QH0100X Clinic/Center Health Service | |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2023-03-21 |