| NPI | 1104117647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA L GOINES CEO 949-214-8559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA 2OA8212) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2011-05-02 |