| NPI | 1518335710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD LEROY GERTSCH Medical Director 858-715-1822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA C35744) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2015-09-04 |