| NPI | 1366898900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MILLER President 760-610-0522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA A82629) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA A82629) |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2016-05-13 |