| NPI | 1750858510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY GRAV VP, Practice Management Operations 657-230-0572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2022-07-29 |