| NPI | 1811564479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN OEI Owner 657-295-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2022-03-16 |