| NPI | 1679600852 |
|---|---|
| Other Name | CHOC CLINIC AT THE BOYS AND GIRLS CLUB OF SANTA ANA |
| Entity Type | Organization |
| Authorized Contact | GINA SUE CADOGAN Billing Manager 714-289-4818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA CM70891F) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |