| NPI | 1154323665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY J MONK Physician Assistant 760-577-6491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient (Licence: 1060858) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2020-08-22 |