| NPI | 1649566225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE ABNEY Executive Director 714-992-1677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 55017) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-06-22 |