| NPI | 1205523958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY J COX CFO 909-464-9675 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2025-01-15 |