| NPI | 1760200356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GHODS CFO 424-440-5585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |