| NPI | 1740654979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY GRISSEN CEO 760-436-8400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: CA 95003464) |
| Enumeration Date | 2015-11-27 |
| Last Update Date | 2015-11-27 |