| NPI | 1487053864 |
|---|---|
| Doing Business As | LOYAL SOURCE GOVERNMENT SERVICES |
| Entity Type | Organization |
| Authorized Contact | VANESSA GAMBALA Msn, Fnp C 619-301-9112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CA 95000947) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |