| NPI | 1992094924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CHARLES PINE Owner 760-360-4888 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C25244) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: CA C25244) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2011-03-30 |