NPI | 1215060397 |
---|---|
Entity Type | Organization |
Authorized Contact | IVAN JOSEPH BATCHKOFF RN 951-443-2200 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA N349190) |
Additional Taxonomies | 305S00000X Point of Service (Licence: CA N349190) |
Enumeration Date | 2007-03-14 |
Last Update Date | 2020-08-22 |