| NPI | 1801011697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAKESHA JOHNSON Billing Manager 760-635-2426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA HK07-1232426HK58) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |