| NPI | 1841656766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA Y EVANS Owner 949-707-5734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A68285) |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2016-01-07 |