| NPI | 1265928212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY DEWAN CEO 949-833-8101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2018-07-02 |