| NPI | 1225011976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA J ANDERSON Medical Biller 949-597-0124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C037249) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C040002) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2020-08-22 |