| NPI | 1871714279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY LEAH LACKIE Office Manager 805-522-3195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A26262) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2017-10-02 |