| NPI | 1548867682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY BRAGANZA Credentialing Manager 562-414-4222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |