| NPI | 1770944027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTAL GACHUPIN AO D Counselor 619-282-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: CA C0502041556) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2016-03-15 |