| NPI | 1194985804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ELIZABETH WILLIAMS Owner 949-681-7204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A73294) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2010-02-01 |