| NPI | 1861892705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO PEVERINI President 909-558-7445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery |
| Additional Taxonomies | 208000000X Pediatrics |
| 208600000X Surgery | |
| 235Z00000X Speech-Language Pathologist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2019-07-19 |