| NPI | 1871838532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDIA OU President 626-393-8885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 12911) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2014-05-20 |