| NPI | 1164698544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARCIE LOPEZ Medical Billing Coordinator 760-863-1592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA A064634) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2017-07-07 |