| NPI | 1811135320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER ROBERTS Sec/Treas 661-374-4949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A89666) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 20884) |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2020-02-06 |