| NPI | 1861858904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP DIMITRIOS KOUROS Medical Doctor 760-948-4219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA G69428) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: CA G69428) |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |