| NPI | 1497913370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHELSEA MARIE APPLEGATE Site Manager 951-256-6307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 631703) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2008-05-28 |