| NPI | 1598791923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY PIERCE MUDGE Medical Director 949-644-2450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2010-06-15 |