| NPI | 1023151974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS MICHAEL KETTEL Officer 858-794-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QA0006X Clinic/Center, Ambulatory Fertility Facility (Licence: CA 080000649) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2018-11-09 |