| NPI | 1053764068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN NGUYEN Manager 714-683-4990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA G71814) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA G67118) |
| 261Q00000X Clinic/Center (Licence: CA A55741) | |
| 261QU0200X Clinic/Center, Urgent Care (Licence: CA G71814) | |
| 261QU0200X Clinic/Center, Urgent Care (Licence: CA G67118) | |
| 261QU0200X Clinic/Center, Urgent Care (Licence: CA A55741) | |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |