| NPI | 1821472135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JON ELDERS Secretary 714-788-1249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN00704) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2021-01-11 |