| NPI | 1174284509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NKOLI ANIGBOGU Medical Director 909-352-6655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2022-10-06 |