| NPI | 1699034827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINGER L LEON Medical Director 909-949-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: CA 20A8311) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2018-06-07 |