| NPI | 1790805570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALDINE LUSKER Billing Specialist 949-275-8895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |