| NPI | 1679890644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA LOURDES DE LOS SANTOS MARA President 619-475-5411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: A51864) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2011-03-09 |