| NPI | 1598989550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY SPARKS Billing Mgr 661-869-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G78490) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G78490) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 4469950001) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2017-02-17 |