| NPI | 1881060135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MIYAWAKI Office Manager 949-632-8087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2015-08-20 |