| NPI | 1588016596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYREYA NOLASCO Office Supervisor 760-843-9414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA 95003242) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2016-07-01 |