| NPI | 1306068499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE GERARD AGUILAR CASPE President 909-899-6969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A97790) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-10-31 |