| NPI | 1477123594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVUNI K HARRISON Billing Manager 909-710-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2021-06-30 |