| NPI | 1215182803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GOSPHA G CAMPBELL Physician 909-890-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA A 102029) |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2012-02-15 |