| NPI | 1720071608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTI JO PETERSON-BALLIET Pediatric Nurse Practitioner 626-536-4774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 286500000X Military Hospital (Licence: AZ RN114749) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2020-08-22 |