| NPI | 1205599149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA HART Billing Manager 949-872-5192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2021-10-18 |