| NPI | 1073962171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARIED BANIMAHD Chief Medical And Executive Officer 949-305-8910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2020-01-10 |