| NPI | 1801277769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA EVISTON Executive Director 661-871-3353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 1467854505) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2015-06-16 |