| NPI | 1417108556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALINDA VANCE Supervisor Billing Support Services 949-574-4652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A50075) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2012-01-31 |