| NPI | 1144574815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER SOROKURS Medical Director 909-592-0142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2012-11-02 |