| NPI | 1871740605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAM M. BUI Medical Doctor 714-545-1133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G59804) |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2020-03-30 |