| NPI | 1831459015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY J GONZALEZ President 909-985-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA G56342) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G56342) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2012-05-22 |