Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner | |
Physician Assistant |
363A00000X | 97 | Physician Assistant |
| NPI Number | 1134669971 |
| LBN Legal business name | CARE CONNECT MEDICAL GROUP |
| Authorized official | LILIAN VILLAREAL - (CFO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 02/27/2017 |
| Last updated | 02/27/2017 - About 9 years ago |
| Identifiers | n/a |
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CARE CONNECT MEDICAL GROUP
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