| NPI | 1437753134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE STEWART Owner 760-638-0890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2020-11-24 |