| NPI | 1386856441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT M. PRATLEY Vice President 714-543-5005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA DC24524) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA C30241) |
| 174400000X Specialist (Licence: CA A-91300) | |
| 174400000X Specialist (Licence: CA A38937) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |