| NPI | 1346488004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL WAYNE GONZALES Owner, President, CFO 858-657-0267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A88738) |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2015-12-17 |