| NPI | 1750216172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENA THONGDARA Intern 714-254-8473 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2026-06-16 |
| Last Update Date | 2026-07-01 |