| NPI | 1316428931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH RUSS President 949-588-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |