| NPI | 1780344820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA RODRIGUEZ Administrator 909-608-7178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-12-29 |
| Last Update Date | 2023-03-28 |