| NPI | 1912724048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIELLE GONZALEZ Credentialing Specialist 909-684-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Additional Taxonomies | 208800000X Urology |
| Enumeration Date | 2024-09-20 |
| Last Update Date | 2024-09-20 |