| NPI | 1710271663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI R GRANESE COO 949-489-5564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C53602) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-07 |