| NPI | 1184777922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CORONA Provider 661-885-7007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 208D00000X General Practice (Licence: CA A61306) | |
| 261QR0200X Clinic/Center, Radiology | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2019-02-13 |