| NPI | 1154555795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | D'MITRI STARKS CEO 909-625-0661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA G49823) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2009-05-12 |