| NPI | 1821282104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRABHAKAR TUMMALA President 909-945-7687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CA A89858) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: CA A89858) |
| 302R00000X Health Maintenance Organization (Licence: CA A89858) | |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2007-08-30 |