| NPI | 1689413650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIEGHART PORNHOLD Owner 714-932-8931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2024-05-21 |
| Last Update Date | 2024-05-21 |