| NPI | 1922486117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY BOTTOMLEY Practice Administrator 909-362-2966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A79221) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2015-05-08 |