| NPI | 1922776996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN HARMON Director Of Clinical Operations 714-707-0855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 2084P0805X |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2022-01-26 |