| NPI | 1952865198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHIE BACON Billing Manager 619-202-6970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-01-22 |