| NPI | 1386761617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENI C MEHTA Office Manager 951-652-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA 00A370440) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2010-09-14 |