| NPI | 1467645762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALESANDRA WILSON Practice Administrator 909-798-3331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA A046504) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA A046504) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |