| NPI | 1538202726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERVAT GAMIL KELADA Administrator 760-355-4150 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A48353) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2018-06-21 |