| NPI | 1285733949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC ADAM LAZZARA CEO 714-544-8167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA 20A7964) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2008-12-05 |