| NPI | 1528591476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANA MORGAN-COOPER Office Administrator 951-279-1172 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 34845) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2017-04-07 |