| NPI | 1902392954 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MELISSA CORONADO VP Of Managed Care 833-696-3349  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease | 
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy | 
| Enumeration Date | 2018-07-02 | 
| Last Update Date | 2025-09-10 |