| NPI | 1962247791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD RODRIGUEZ Owner 661-496-5950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2024-06-25 |