| NPI | 1477925972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PIERRE FAYO FIRMALINO President 909-393-5501 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 39402) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |