| NPI | 1689983926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN KEITH PRINCE Officer/Authorized Official 619-929-1836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2021-05-10 |