| NPI | 1912004193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE F MIZE Medical Director 805-614-5220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 050000516) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |