| NPI | 1669544193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA WALDROP WARREN Owner 661-412-7784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: AL DO523) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2010-09-17 |