| NPI | 1356600589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARDO CANCHOLA Medical Director 714-870-1888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA G55328) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2012-05-08 |