| NPI | 1093197816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY YANG CEO 949-892-9088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CA oms84) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA 103339) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-06-29 |