| NPI | 1508207234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCE HENRY BOGGELN Owner/CEO 951-676-8868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA G49322) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G49322) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-10 |