| NPI | 1902111834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLU CHENNA REDDY CEO/Director 909-623-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2023-08-21 |