| NPI | 1366635609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANDAKUMAR B. RAVI Owner/Secretary 661-637-1005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2015-04-27 |