| NPI | 1366856841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA A REDDY President 619-427-1721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA A115598) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A115598) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2016-06-14 |