| NPI | 1316366560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRENALYN DOMINGO President 909-709-7941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP 13242) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |