| NPI | 1497996664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOLORES L. FAZZINO President 760-579-2440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP11272) |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2009-03-17 |