| NPI | 1790352995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOON BURNAM Treasurer 949-540-1249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2021-06-07 |