| NPI | 1386980555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL TOLLEFSON Supervisor 951-778-3504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CA HO502091228) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2012-12-17 |