| NPI | 1982354577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY LEWIS Medical Director 951-363-0243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2022-03-25 |