| NPI | 1326880980 |
|---|---|
| Doing Business As | SQUARE ONE MEDICAL |
| Entity Type | Organization |
| Authorized Contact | JOHN KENNETH GERARD Owner 760-286-9946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2024-06-12 |