| NPI | 1487191516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARDO CANCHOLA Owner 714-662-7710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA G55328) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2022-11-15 |