| NPI | 1588023295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN GARRETT Biller 951-766-6460 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 00G55989) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A42484) |
| 174400000X Specialist (Licence: CA G05779) | |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2016-02-23 |