| NPI | 1366645145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES T WANG Owner 949-888-9288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G79462) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: CA 05D1021032) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2021-03-22 |