| NPI | 1184200339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN OPARA Administrator 909-908-0371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZC0006X Pathology, Clinical Pathology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2021-04-06 |