| NPI | 1801307368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LALLY President 909-281-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2023-10-19 |