| NPI | 1174895221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN KAWADA Billing Manager 949-270-0344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA G15060) |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2012-02-06 |