| NPI | 1326145756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITA C JACKSON President 951-694-4688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: CA A053675) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |