| NPI | 1013138486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSELYN MARIE JOHNSON Registered Nurse 714-836-5447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2022-07-21 |