| NPI | 1578365136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KIMBER Chief Business Development Officer 858-344-7887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2025-03-25 |
| Last Update Date | 2025-03-25 |