| NPI | 1851505432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | P. PERRY WICH Physician 909-946-3826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A32660) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |