| NPI | 1275764706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RO JONG PARK President 858-277-7111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA C51913) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C51444) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2015-03-20 |