| NPI | 1801260773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD GOLLIN President 909-633-5238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CA G084953) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2015-11-16 |