| NPI | 1366659054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TWEEDELL Deputy Director 951-358-5222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP16928) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |