| NPI | 1699549311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIE MICHAEL MEYERS Administrator 619-310-3633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2025-06-18 |