| NPI | 1982129342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOFIA HENDERSON President 951-443-9606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 51407) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2017-08-07 |