| NPI | 1588203988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANTE CERVANTES Medical Staff Services Specialist 909-277-2420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2023-02-15 |