NPI | 1336650068 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT STEPHEN JENNINGS President 949-500-5662 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
207QA0505X Family Medicine, Adult Medicine | |
207QG0300X Family Medicine, Geriatric Medicine | |
207QS0010X Family Medicine, Sports Medicine | |
Enumeration Date | 2017-10-20 |
Last Update Date | 2018-01-04 |