| NPI | 1215079892 |
|---|---|
| Doing Business As | GENESIS MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | TERRY KB FOWLER President 714-522-2891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A7881) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 00AX78810) |
| 207Q00000X Family Medicine (Licence: CA 20A7613) | |
| 207Q00000X Family Medicine (Licence: CA A43569) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2008-07-03 |