| NPI | 1205802717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVOR J NAZARETH Owner 760-568-3563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A30151) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2008-09-08 |