| NPI | 1487004032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA NGUYEN Administrator Assistant 714-307-8797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 41290) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2018-04-24 |