| NPI | 1609319946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENCHANTA L. JENKINS Owner 760-909-9435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA c3940420) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2022-09-26 |