| NPI | 1306194261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED F SOEPRONO President 951-203-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: CA G28216) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: CA 005D0573825) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2012-09-06 |