| NPI | 1164527271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIDOZIE CONSTANCE MBAGWU Medical Director 951-324-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA A513990) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-08-22 |