| NPI | 1154173508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOON BURNAM Treasurer 949-540-1249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine | |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |