| NPI | 1952711517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA R SHERIDAN Osteopathic Physician 760-451-8815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A12819) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2014-05-05 |