| NPI | 1093158750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY S KELLER President 805-687-6408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA G22919) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2013-04-12 |