| NPI | 1912395435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE STEPHEN DYSINGER CEO 951-742-7324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2025-04-28 |