| NPI | 1578618088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY M OLIVERIO Administrator 951-849-1950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 00A450420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 00A332270) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2012-09-11 |