| NPI | 1912345406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANCE THE NGUYEN CEO 909-613-1644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 9741) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2013-06-06 |