| NPI | 1164053104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR R POLLEI CEO/Provider 949-998-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Additional Taxonomies | 208600000X Surgery |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2023-04-26 |