| NPI | 1386827749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENGIS RIZNIS CEO 760-219-1311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A86212) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA A86212) |
| Enumeration Date | 2007-12-08 |
| Last Update Date | 2008-07-09 |