| NPI | 1730834904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY RENELL TANNER Admnistrator 714-394-6465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2022-02-16 |
| Last Update Date | 2023-07-31 |