| NPI | 1972794089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOMBATH SENETHONG Director 619-262-8626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CA 208D00000X) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |