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 |