| NPI | 1235813528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE KIM CEO 909-238-7966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-06-15 |