| NPI | 1902193170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETICIA AMADOR Physician Assistant 951-684-4310 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G55320) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2013-04-18 |