| NPI | 1437379187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE JOHNSON Consultant 909-944-6688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |