| NPI | 1902234230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY WONG Medical Director 714-771-9252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA G45605) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2013-10-23 |