| NPI | 1033914924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAM DO CEO 949-436-4666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM2500X Clinic/Center Medical Specialty | |
| Enumeration Date | 2025-02-15 |
| Last Update Date | 2025-04-11 |