| NPI | 1578861613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES POTTER STIVERS Chief Financial Officer 949-226-1733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: CA A72318) |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2011-03-12 |
| Last Update Date | 2024-03-01 |