| NPI | 1316200108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD M PATRAGNONI Medical Director 949-891-0328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A62815) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2017-05-10 |