| NPI | 1518348481 |
|---|---|
| Doing Business As | SPECIALIZED AMBULATORY GERIATRIC EVALUATION |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DOAN Chief Compliance Counsel 909-235-4307 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 930000149) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2015-06-16 |