| NPI | 1811149677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENRICK ANTHONY LICORISH CEO 714-460-2948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: A37875) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: A37875) |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2008-10-10 |