| NPI | 1669562765 |
|---|---|
| Doing Business As | LA COSTA URGENT CARE AND FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | GREGORY LANCE WAKEMAN Chief Executive Officer 760-603-3221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A6797) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-10-30 |