| NPI | 1568172484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA LYNN MONTE Billing Manager 909-542-2898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2022-12-01 |