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1588036289
SUSAN SAMUELI CENTER
COSTA MESA, CA
NPI
1588036289
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Entity Type
Organization
Authorized Contact
MANUEL PORTO
President & C.E.O.
714-456-2986
Organization Subpart ?
Yes
Primary Taxonomy
261QM1300X Clinic/Center, Multi-Specialty
Enumeration Date
2015-10-21
Last Update Date
2015-10-21
Business Address
SUSAN SAMUELI CENTER
1202 BRISTOL ST SUITE 200
COSTA MESA, CA 92626-8605
Phone number: 714-424-9001
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Mailing Address
SUSAN SAMUELI CENTER
PO BOX 54559
LOS ANGELES, CA 90054-0559
Phone number: 714-456-3724
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