| NPI | 1154317584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL E YOUNG Administrator 909-592-2145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A33406) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: CA A43523) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2020-08-22 |