| NPI | 1689423006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVANGELINE NADEAU Owner 949-866-8818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-05-16 |