| NPI | 1962769539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA VIRGINIA G SIOSON AYALA President 626-375-7435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A105436) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2013-04-05 |