| NPI | 1902827116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA M WALLACE Medical Biller 619-299-2570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A33711) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A33711) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2015-05-15 |