| NPI | 1942482021 |
|---|---|
| Doing Business As | OPTUM |
| Entity Type | Organization |
| Authorized Contact | ASHLEY GRIM Practice Administrator 909-793-3208 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2022-07-28 |