| NPI | 1245698323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAJIA MONUGION N/A 909-373-4633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| 246RP1900X Technician, Pathology, Phlebotomy | |
| 246Z00000X Specialist/Technologist, Other | |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | |
| 247200000X Technician, Other | |
| 251K00000X Public Health or Welfare | |
| 261QA1903X Clinic/Center, Ambulatory Surgical | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery | |
| 302F00000X Exclusive Provider Organization | |
| 305R00000X Preferred Provider Organization | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2016-02-04 |