| NPI | 1518455419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLIAN S GRAY Owner 714-941-2259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2020-11-13 |