| NPI | 1679231344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA ESMERALDA ZARAGOZA Credentialing Manager 951-492-9614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TR0400X Psychologist, Rehabilitation | |
| 111N00000X Chiropractor | |
| 111NR0400X | |
| 111NX0800X Chiropractor, Orthopedic | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2021-11-30 |