| NPI | 1669977021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PAUL WATSON Medical Director 805-723-8008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 207N00000X Dermatology |
| 2086S0122X Surgery Plastic and Reconstructive Surgery | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |