| NPI | 1790172997 |
|---|---|
| Doing Business As | KINGS AND QUEENS |
| Entity Type | Organization |
| Authorized Contact | SHAKUR ESSA ELMI Manager/Member 858-610-8229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2015-04-25 |