| NPI | 1487363321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY QUACH Credentialing Coordinator 714-799-5058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 2086S0129X |
| Enumeration Date | 2022-11-18 |
| Last Update Date | 2022-11-18 |