| NPI | 1518184886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTIE JEAN DIMMETTE Owner 951-461-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: CA G66939) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2019-05-16 |