| NPI | 1619622636 |
|---|---|
| Doing Business As | MY PEDIATRIC HOME |
| Entity Type | Organization |
| Authorized Contact | JENNIFER COBANOV CEO/Medical Director 909-647-8783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2022-02-17 |