| NPI | 1700811304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DEE STANSELL President 760-778-6769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA 2818892) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2008-08-14 |