| NPI | 1639691397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA L SANDERSON Clinic Manger 661-993-8941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA 20A6613) |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation (Licence: CA 20A6613) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2017-07-28 |