| NPI | 1679100911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIOMA KALU Md/CEO 909-402-4601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2022-03-28 |