| NPI | 1336499300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PHILLIP EVERHEART RN Fa 949-683-8539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 519519) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA 519519) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2012-09-17 |