| NPI | 1649835182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALVATORE R CAMPO Physician/President 800-246-5698 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2019-06-11 |