| NPI | 1932471125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDITH L KORNBERG Secretary/Treasurer 858-459-8874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA G13900) |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2012-02-02 |