| NPI | 1356463913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ELAINE BONELLI Corporate Administrator 760-685-4096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 030000552) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2021-12-28 |