| NPI | 1770062374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESERIE TSOSIE Credentialing 661-673-6726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 208D00000X General Practice |
| 363LF0000X Nurse Practitioner, Family | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2018-08-14 |