| NPI | 1194712315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH ANN NOVELLINO Executive Director 951-774-2881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2013-07-03 |