| NPI | 1861456634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY ANN GLASS Office Manager 760-946-4840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A46329) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A50460) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2008-06-12 |