| NPI | 1487947842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB NAVA FLORES Chief Medical Officer, Cmo 760-809-4045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: CA A60865) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2021-05-13 |