| NPI | 1962659573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD KANGAH Medical Director/President 909-864-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A55122) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2009-03-04 |