| NPI | 1124187562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN PARROTT Administrator 949-726-0682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 060000436) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |