| NPI | 1164699880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLEY SHARIFI Credentialing Manager 714-500-7714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: CA G35672) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2021-10-22 |