| NPI | 1851057715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DALIVA Owner 909-227-0750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2025-10-03 |