| NPI | 1457300436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S. CHIN President 951-278-8870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G56529) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 20A10803) |
| 208600000X Surgery (Licence: CA G75730) | |
| 208600000X Surgery (Licence: CA 20A9434) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CA PA16804) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2021-12-28 |