| NPI | 1184041980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDA CEBALLOS CFO 619-208-6318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: CA BS2014005590) |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2014-03-18 |