| NPI | 1356811061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZORAN RUBAKOVICH Administrator 760-346-4003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2018-11-26 |