| NPI | 1265651756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE B. POTTS Owner 559-738-0450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA G64819) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2011-03-16 |