| NPI | 1477067882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM C WALLACE Owner/CEO 949-457-7900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |