| NPI | 1508158957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNA THORBJORNSEN Office Manager 909-396-0309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A45671) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |