| NPI | 1649598772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSCAR MANUEL DE LA MORA Owner 619-264-3107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C50916) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A30061) |
| 208000000X Pediatrics (Licence: CA A50769) | |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2010-05-13 |