| NPI | 1639406101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA LEWIS CEO 424-750-9198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 1477714020) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2009-11-13 |