| NPI | 1306881297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYN JARALD HENDERSON President/Owner 714-741-0622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A4401) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-08-22 |