| NPI | 1184683930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE LYNN WERTHEIMER-GALE Director 949-551-4233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA OT 5104) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-08-22 |