| NPI | 1548803554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL RAFAEL LAZO Owner 619-482-8608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282N00000X General Acute Care Hospital |
| Additional Taxonomies | 122300000X Dentist |
| 207Q00000X Family Medicine | |
| 208600000X Surgery | |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-10-22 |