| NPI | 1669857637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA OLASABA Office Manager 714-432-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: CA A102841) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA A102841) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-07-20 |