| NPI | 1194217588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBEN A HERNANDEZ Owner/Provider 661-945-4581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A74132) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 16240) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-06-01 |