| NPI | 1790031037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MARIE BEMIS Authorized Official 858-504-5667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2023-11-09 |