| NPI | 1174346498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN MARTIN PHELPS President 760-400-6375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2024-12-10 |