| NPI | 1407910250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA PETERSON Superintendent 626-307-3427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA RN422810) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |