| NPI | 1770858441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA FELCE Credentialing Manager 949-282-1671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CA 579745) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2012-03-14 |