| NPI | 1407096720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JAMES LICATA Owner 714-827-8890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A25662) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA A25662) |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2011-04-15 |