| NPI | 1629027255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ALICE SPEAK Administrator 909-357-1595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A74033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA NP7110) |
| 207P00000X Emergency Medicine (Licence: CA 20A6914) | |
| 207PE0004X Emergency Medicine Emergency Medical Services (Licence: CA A45447) | |
| 207Q00000X Family Medicine (Licence: CA A36223) | |
| 207Q00000X Family Medicine (Licence: CA G67483) | |
| 207R00000X Internal Medicine (Licence: CA A75923) | |
| 207R00000X Internal Medicine (Licence: CA A62436) | |
| 207R00000X Internal Medicine (Licence: CA G80704) | |
| 207R00000X Internal Medicine (Licence: CA A32826) | |
| 207R00000X Internal Medicine (Licence: CA A51183) | |
| 208000000X Pediatrics (Licence: CA A41815) | |
| 208000000X Pediatrics (Licence: CA A85338) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2007-10-09 |