| NPI | 1346107141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONIELLE GREEN Medical Director 909-279-5996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2026-01-06 |
| Last Update Date | 2026-05-19 |