| NPI | 1902959075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCISCO A JIMENEZ Medical Director 909-391-3616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A40305) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A40070) |
| 208000000X Pediatrics (Licence: CA G15628) | |
| 213E00000X Podiatrist (Licence: CA E3702) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2012-07-02 |