| NPI | 1699374256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO GODOY Medical Director 702-631-6863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2025-03-03 |