| NPI | 1114192390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY MARTINEZ Office Manager 714-502-1144 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 305S00000X Point of Service (Licence: CA 00A325660) |
| 305S00000X Point of Service | |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2022-07-20 |