| NPI | 1346119054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARITY EZEAMAMA Physician Assistant 909-268-4181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2025-10-31 |
| Last Update Date | 2025-10-31 |