| NPI | 1730124124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSIE MORENO Supervisor 805-287-9107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: CA 050000572) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2019-05-24 |