| NPI | 1386647527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL PETRIE Chairman 949-782-5038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 060000520) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2023-09-25 |