NPI | 1740507607 |
---|---|
Entity Type | Organization |
Authorized Contact | ALVARO BOLIVAR Owner 909-888-5552 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 208600000X Surgery |
Enumeration Date | 2010-04-30 |
Last Update Date | 2013-05-22 |