| NPI | 1124329594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE JAMES JEKUMS President 714-535-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G23626) |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2012-11-01 |