| NPI | 1770033276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARITA WAGNER Credentialing Manager 951-369-9853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A85970) |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-10-07 |