| NPI | 1225206816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER MAILE TOMLIN Billing Coordinator 949-637-3796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A34073) |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2008-02-15 |