| NPI | 1750917944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKAN KHATIBI CEO 949-842-9628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| 208VP0000X | |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2021-08-17 |