| NPI | 1124563564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CONSTABLE Business Manager 949-232-1988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2016-12-20 |
| Last Update Date | 2017-01-19 |