| NPI | 1881015584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KUMARAVELU BALASUBRAMANIAM Medical Director 909-881-3032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2013-12-23 |