| NPI | 1033222989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY REED Manager 661-335-7755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: CA Z18704) |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2018-04-05 |