| NPI | 1194274167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WELIM AZINGE President 619-916-3177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A126925) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A126925) |
| 208600000X Surgery (Licence: CA A126925) | |
| 208D00000X General Practice (Licence: CA A126925) | |
| 261QH0100X Clinic/Center, Health Services (Licence: CA A126925) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: CA A126925) | |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA A126925) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CA A126925) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: CA A126925) | |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2018-03-14 |