| NPI | 1366255119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER A MIEDICO Medical Services Administrator 858-974-5824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-02-04 |