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1871953745
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SANTA ANA, CA
NPI
1871953745
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Other Name
SOS
Entity Type
Organization
Authorized Contact
KATHLEEN BRUSKI
Credentialing Manager
949-270-2132
Organization Subpart ?
No
Primary Taxonomy
261Q00000X Clinic/Center
Enumeration Date
2016-03-04
Last Update Date
2016-03-04
Business Address
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1014 N BROADWAY
SANTA ANA, CA 92701-3408
Phone number: 949-270-2132
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Mailing Address
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1550 SUPERIOR AVE
COSTA MESA, CA 92627-3653
Phone number: 949-270-2132
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