| NPI | 1124411400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA SULLIVAN Manager 760-837-0364 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA A61113) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-03-11 |