| NPI | 1245893775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE FRANCO Provider 661-304-6970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2019-07-02 |