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 |