| NPI | 1861546681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY C HUGHES Owner 951-925-9565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G59842) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: CA G59842) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: G59842) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: G59842) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2014-12-23 |