| NPI | 1356710495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON EALY BLACKWELL Assitant 909-792-8866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA NP95002812) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2015-09-18 |