| NPI | 1245489384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PADMA KHANCHUSTAMBAHM Owner 760-464-2166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A86478) |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2016-05-03 |