| NPI | 1134508955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE WALKER Contracts Manager 909-398-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C40547) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |