| NPI | 1316440811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE MICHELLE SOTO Billing Manager 760-375-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2018-03-12 |