| NPI | 1215026653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MARC ALDERMAN Medical Physician 760-416-4819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A50964) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |