| NPI | 1982698007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIBUL TANGPRAPHAPHORN Physician 661-765-4124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA a33497) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2023-03-07 |