| NPI | 1841509064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA FORSYTHE Business Manager 661-322-8466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA A38980) |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2010-10-05 |