| NPI | 1538480298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAOMI DENNIS Hsc/ Clinic Administrator 619-524-5204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient (Licence: VA 0101056076) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2010-06-17 |