| NPI | 1578196606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUMBERTO ROBERT INZUNZA CEO / Pa C 661-221-2552 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2020-04-15 |