| NPI | 1982585980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MASTANEH NIKRAVESH Physician/Owner 619-869-9953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2025-09-08 |
| Last Update Date | 2025-09-08 |