| NPI | 1235203233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY ROY Controller 909-473-1980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 240000858) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-10-15 |