| NPI | 1578604591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE Director Of Operations 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site (Licence: OR MD20007) |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2023-01-26 |