| NPI | 1467732057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER SALEM Owner 949-260-0744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A10607) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2020-11-10 |