| NPI | 1447572029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNADETTE F COSTA Billing Manager 909-882-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A33374) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2010-02-23 |