| NPI | 1457676249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK BARTLETT KISTLER President 951-682-6263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA C26186) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2010-04-05 |