| NPI | 1447561162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN S. WILBUR Medical Director 909-483-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 3281697) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2011-09-19 |