NPI | 1609965748 |
---|---|
Entity Type | Organization |
Authorized Contact | REYNALDO O GOMEZ Physician 760-416-3390 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: CA A51395) |
Additional Taxonomies | 174400000X Specialist (Licence: CA G86746) |
Enumeration Date | 2006-10-12 |
Last Update Date | 2020-08-22 |