| NPI | 1508489600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BOWMAN Director Of Operations 949-292-7510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2020-05-22 |