| NPI | 1740691047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL BUSTAMANTE Executive Administrator 844-636-6245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: CA 55037) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2014-05-09 |