| NPI | 1437340692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN TERESA SONG Owner 949-748-8866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A86825) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A86825) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |