| NPI | 1164500559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEROSO SANTOS NERY President 909-931-1368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A31007) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-08-30 |