| NPI | 1134864622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASIL ISSA CEO 714-683-8287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2024-06-11 |