| NPI | 1104969179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALL LEWIS Director 661-822-2890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 120000546) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-11-09 |