| NPI | 1598270993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN ELIZABETH CASTANEDA FASSIOLI CEO 949-716-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 101094) |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2022-02-11 |