| NPI | 1720675986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY J COX CFO 909-464-9675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2020-12-22 |