| NPI | 1215452040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE EVANS Credentialing Specialist 951-234-0041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2017-08-14 |