| NPI | 1457088437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN CORDERO Owner 833-854-3131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2023-08-01 |