| NPI | 1871837013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIRLIE AQUINO UY President 951-352-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 56967) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: CA 56967) |
| 305S00000X Point of Service (Licence: CA 56967) | |
| Enumeration Date | 2012-11-11 |
| Last Update Date | 2012-11-11 |