| NPI | 1518136787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA PERKO CFO 909-335-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2009-09-11 |