| NPI | 1124248844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA R DOMINGUEZ Office Manager 951-785-7190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: CA A41709) | |
| 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: CA A41709) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2022-09-09 |