NPI | 1831602655 |
---|---|
Entity Type | Organization |
Authorized Contact | OCTAVIO RUIZ-VILLALPANDO Medical Director 909-219-5260 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A92039) |
Enumeration Date | 2017-11-15 |
Last Update Date | 2017-11-15 |