| NPI | 1629287578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD BLAKE Md 909-882-3962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |