| NPI | 1881832962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK C. SHEA President 949-642-7882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: CA 11538TPL) |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health (Licence: CA 11538TPL) |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2009-03-03 |