| NPI | 1477554707 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | LESLIE ANN GIBOLA Owner 949-457-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CA 103801) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2012-06-19 |