| NPI | 1053568030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY GILBERT DING Medical Director 949-444-1886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A66008) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2017-04-13 |