| NPI | 1225405962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERVAT GAMIL KELADA Md/Administrator 760-562-6633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: CA a48353) |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2015-08-28 |