| NPI | 1740303924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEAU MICHAEL CHUNG Medical Director 949-274-8807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G36420) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2019-07-11 |