| NPI | 1619522893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDOUARD E RIVERA Statutory Agent 949-723-9603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2021-08-24 |