| NPI | 1770042129 |
|---|---|
| Doing Business As | KOMAN FAMILY OUTPATIENT PAVILION |
| Entity Type | Organization |
| Authorized Contact | LORI DONALDSON CFO 619-543-6613 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2019-03-15 |