| NPI | 1841419454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILLIS PUCKETT Vascular Surgeon 949-574-7176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CA G38172A) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2014-02-03 |