NPI | 1881690949 |
---|---|
Entity Type | Organization |
Authorized Contact | SUZI MICHELLE CUNNINGHAM Administrator 909-560-5125 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 550000011) |
Enumeration Date | 2005-06-23 |
Last Update Date | 2020-08-20 |