| NPI | 1558068759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELICA K ALDARACA Credentialing Manager 909-236-7994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RN0300X Internal Medicine, Nephrology | |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2025-11-13 |