| NPI | 1295971778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EDWARD ENGELHARDT President 909-931-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA G63529) |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2019-01-17 |