| NPI | 1902313919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA KENEFICK FAVOR Accountant 949-829-8299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2019-10-03 |