| NPI | 1811652035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH MOZINGO Authorized Official 805-563-0363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2026-03-05 |