| NPI | 1710347737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBY J SHAH Member Manager 951-314-2930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX Q6034) |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2022-03-15 |