| NPI | 1285029140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE STANLEY WILDISH Secretary/Treasurer 951-368-0428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A65963) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-03-31 |