| NPI | 1306395587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUTHER MANGOBA CEO/President 951-687-0004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CA 3942935) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 3942935) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-09-29 |