| NPI | 1306355714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY VANDENBERG President 858-453-3813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA C33053) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2022-07-21 |