| NPI | 1295088466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN KABONGO CEO 760-520-1920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA fnp41999) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2012-10-24 |