| NPI | 1730360579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL I DOMINGO Director 909-467-1445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A53766) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A53766) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2023-09-14 |