| NPI | 1700214780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO PEVERINI President 909-558-7448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 204F00000X Transplant Surgery |
| 363A00000X Physician Assistant | |
| 363AS0400X Physician Assistant, Surgical | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2020-05-05 |