| NPI | 1043515604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BABAK R SHAHRESTANI President 949-631-3139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA 19600) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA 19600) |
| Enumeration Date | 2011-01-12 |
| Last Update Date | 2011-01-12 |