| NPI | 1962622803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN REGH CAMOTES GABRILLO President 909-982-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A51794) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2010-02-03 |