| NPI | 1225304967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PUNEH BAHA Owner/President 858-755-9465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 11596T) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2012-05-02 |