| NPI | 1619244670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE TYSON Md 661-948-2400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2011-11-18 |