| NPI | 1609332394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH KILLEBREW Member 714-698-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2019-07-02 |