| NPI | 1265967491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEHBOOB GHULAM Owner 760-351-4848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2019-02-03 |