| NPI | 1629504915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIPUL R DEV Owner 661-327-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA a63639) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2017-05-05 |