| NPI | 1528433687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL ENTIENZA VILLARUBIA President 714-635-2388 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 55505) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |