| NPI | 1760662886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA J CAPATOSTO Billing Specialist 661-947-3299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A18590) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2007-11-13 |