| NPI | 1497942932 |
|---|---|
| Former Legal Business Name | FOUNTAIN VALLEY PEDIATRIC SPECIALISTS, INC. |
| Entity Type | Organization |
| Authorized Contact | KENNETH KIM President 714-506-8094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2007-09-28 |