| NPI | 1073272167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN REID BEECHER Clinical Administrator 949-993-7432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0505X Family Medicine Adult Medicine | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2023-03-09 |