| NPI | 1619112315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALWIN WILLIAM BAGINGITO Director/M.D. Provider 951-695-6787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: CA G66628) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2008-12-09 |