| NPI | 1811218688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY EDWARD LOSASSO Owner 760-634-4090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CA G41471) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2010-12-10 |