| NPI | 1972076644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARITZA HARRISON CEO 951-202-9083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-01-06 |
| Last Update Date | 2024-10-24 |