| NPI | 1215773544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA CHUNG President 909-632-0895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2024-07-05 |