| NPI | 1144878414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE WALTON Enrollment Manager 951-900-3156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2020-06-10 |