| NPI | 1659641124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE D PROFFITT Medical Provider 661-326-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA13811) |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2011-12-30 |