| NPI | 1942515986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY K HOTTMANN-WENGER Owner 760-436-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA PA15954) |
| Enumeration Date | 2010-08-14 |
| Last Update Date | 2010-08-14 |