| NPI | 1770395782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDUL H REZAHI Owner 689-236-0028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2025-01-25 |
| Last Update Date | 2025-08-13 |