| NPI | 1871337998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBI THOMAS President 661-624-4931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2024-06-24 |