| NPI | 1285838425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL V. ELAM Owner 949-721-1113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA C38533) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-08-22 |