| NPI | 1588105142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN RICHARDSON Manager 714-587-1458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 68748) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |