| NPI | 1740554120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE WATTS Assistant Surgeon 858-922-3145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 18112) |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2012-03-01 |