| NPI | 1205713682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATUM JESTILA CEO 661-404-4086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2085R0203X Radiology, Therapeutic Radiology | |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RI0011X Internal Medicine, Interventional Cardiology | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-08-19 |