| NPI | 1265984223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA ANN BENDER President/Owner 760-565-6376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RS0010X Internal Medicine, Sports Medicine | |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2020-05-22 |