| NPI | 1194174425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAKE EUGENE FLEMING CEO 858-587-1822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: CA 20A11169) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2016-06-07 |