| NPI | 1720933179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORIE DANG Manager Of Operations 714-495-0905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2026-03-02 |
| Last Update Date | 2026-07-15 |