| NPI | 1003216276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOUROS AZAR Manager 805-373-7073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA A79029) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2014-11-20 |