| NPI | 1124521018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TY HECKMAN Manager 661-327-2101 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A63639) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RI0011X Internal Medicine, Interventional Cardiology | |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2023-06-12 |