| NPI | 1932353166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LOPEZ IBARRA Medical Provider 559-255-0496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA G73482) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2008-11-17 |