NPI | 1205507415 |
---|---|
Entity Type | Organization |
Authorized Contact | INDIGO ALLENDORF Executive Director 657-422-7586 |
Organization Subpart ? | No |
Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
Enumeration Date | 2021-09-27 |
Last Update Date | 2021-09-27 |