| NPI | 1649160169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CALTZONTZINT Manager 760-994-2272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-07-07 |
| Last Update Date | 2025-07-07 |