| NPI | 1508373119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LALLY Cmo 909-281-5800 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2025-09-02 |