| NPI | 1326573437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE DE LA LLANA Primary Care Provider 909-931-0069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A44835) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2020-01-24 |