| NPI | 1427101369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA BENAVIDEZ Administrator 909-373-8222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A6396) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A8664) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2014-04-02 |