| NPI | 1225343320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL BROOK CHANNELL Physician/President 909-981-4955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA G85321) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |