| NPI | 1508110503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LEE MCKERAHAN Physician 951-696-9566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA 20A6780) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-11-13 |