| NPI | 1558435263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY F MOORE CEO 760-242-4101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA A41582) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |