| NPI | 1720183403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY D ATWOOD Director Business Services 951-782-5136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2022-07-21 |