| NPI | 1144049560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATHAR MASOOD ANSARI Owner/Authorized Official 760-353-3222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2024-10-10 |