| NPI | 1164945515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ONEIL Director 949-412-5129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| 207PS0010X Emergency Medicine, Sports Medicine | |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-07-18 |