| NPI | 1114069549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELEANOR MARIE KELLY Director 949-735-0174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A064544) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2015-12-28 |