| NPI | 1689082711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA BOLIVAR Administrator 909-888-8154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A41590) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2023-04-27 |