| NPI | 1932861176 |
|---|---|
| Doing Business As | COACHELLAMED |
| Entity Type | Organization |
| Authorized Contact | CARLOS LOPEZ President 760-413-5027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2021-12-03 |