| NPI | 1417517731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK FIGUEROA Secretary 909-800-3426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
| 363LF0000X Nurse Practitioner, Family | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2019-06-18 |