| NPI | 1508153297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA GERALDINA FUENTES President 619-941-1545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A83896) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2014-05-20 |