| NPI | 1548427032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALONZO ELLIS LOCKHART Medical Director 714-547-6543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C42439) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-05-21 |