| NPI | 1225471956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEAZA Z. KIDANE President 951-571-0632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA PA20768) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2013-04-11 |